Data Aggregator Validation – Pilot Launched

NCQA launched a pilot of our new Data Aggregator Validation (DAV) program in March 2020.

The DAV program aims to validate aggregators (e.g., Health Information Exchanges) that collect, aggregate, and transform data from original data sources on behalf of vendors and healthcare organizations. The pilot hopes to demonstrate that aggregators meeting NCQA’s standards and protocols have achieved a high enough standard that their data can be leveraged by organizations as standard supplemental data or as abstracted medical records.

WHAT’S THE IDEA?

Rules for HEDIS reporting require the Licensed Organization auditing a health plan to go back to the original data sources to check  validity during the HEDIS audit®.

The time and expense to verify original source data discourages plans from working with data from aggregators

  • The DAV program would check data coming in and out of aggregators, so health plans and auditors don’t have to do this during the HEDIS Audit.
  • By “validating the aggregator,”NCQA will improve ease and accuracy of HEDIS data collection and reporting.

WHAT’S THE BENEFIT FOR AGGREGATORS?

  • Validation of Inputs: NCQA check of the completeness, accuracy and reliability of data that aggregators ingest from EHRs, labs, pharmacies, and other sources.
  • Validation of Outputs: NCQA checks that the aggregator can produce a clean Continuity of Care Document (CCD)—data in a standardized format that the aggregator can pass to health plans for HEDIS reporting.
  • An Opportunity to Grow: Data hubs that have earned NCQA Validation would become “standard supplemental data” sources for health plans. This status will make data aggregators attractive partners for health plans and enhance aggregators’ role in quality reporting.

An Alternative to Full eCQM Certification: Organizations that do not aspire to do the complete measure reporting that our eCQM Certification evaluates would earn an NCQA seal for demonstrating they can pass valid files for plans to use as supplemental data.

Eligibility would be broad. Almost any “hub” that aggregates data would qualify to earn the NCQA seal if the aggregator meets standards.

Annual revalidation would be a valuable double-check to sustain confidence in data.

WHAT’S NEXT?

A pilot is currently underway in a large state and NCQA expects it to be completed in the summer of 2020. It is not yet a NCQA product. Results from the pilot  will affect:

  • Whether we develop a Data Aggregator Validation (DAV) program.
  • Details and requirements of the DAV program.DAV program could possibly be available in late 2020, in time for reporting HEDIS Measurement Year 2020 results in June 2021.

Contact us at MyNCQA (the HEDIS Audit queue) with questions about the DAV program.

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